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Factors affecting survival time of cholangiocarcinoma patients: a prospective study in Northeast Thailand
Somkiattiyos Woradet1, Supannee Promthet, Nopparat Songserm
1Department of Epidemiology, Faculty of Public Health, Khon Kaen University, Thailand.
Insights
Cholangiocarcinoma (CCA) survival is poor in Northeastern Thailand, with a median of 4.3 months. Advanced stage, jaundice, ascites, and elevated CEA negatively impact outcomes, while standard treatment improves prognosis.
Area of Science:
- Hepatobiliary Malignancies
- Gastroenterology
- Epidemiology
Background:
- Cholangiocarcinoma (CCA) represents a significant public health concern and cause of mortality in Northeastern Thailand.
- Understanding prognostic factors is crucial for improving patient outcomes in this high-incidence region.
Purpose of the Study:
- To investigate survival time and identify independent prognostic factors for cholangiocarcinoma (CCA) patients in Northeastern Thailand.
- To evaluate the impact of clinical presentation and treatment on CCA patient survival.
Main Methods:
- Prospective cohort study involving 171 newly diagnosed CCA patients across five tertiary hospitals.
- Follow-up conducted from February 2011 to January 2012, recording survival time and clinical data.
- Cox's proportional hazard model utilized to analyze factors influencing survival.
Main Results:
- The median survival time for CCA patients was 4.3 months.
- Factors significantly associated with shorter survival included advanced stage at diagnosis, jaundice, ascites, and positive serum carcinoembryonic antigen (CEA).
- Patients receiving standard treatment demonstrated a better prognosis (HR: 0.5).
Conclusions:
- CCA in Northeastern Thailand is associated with poor survival, influenced by disease stage and clinical indicators.
- Early diagnosis and standard treatment are critical for improving the prognosis of CCA patients in this region.
Abstract:
Cholangiocarcinoma (CCA) is a major health problem and cause of death among people in Northeastern Thailand. In this prospective study 171 patients newly diagnosed with CCA by physicians in 5 tertiary hospitals in four provinces of northeastern of Thailand between February and July 2011 were followed up to January 2012. The outcome was survival time from diagnosis to death. A total of 758.4 person-months of follow-up were available. The mortality rate was 16.9 per 100 person-months (95%CI: 14.1-20.1). The median survival time among CCA patients was 4.3 months (95%CI: 3.3-5.1). Cox's proportional hazard model was used to study the independent effects of factors affecting survival time among patients. Statistically significant factors included advanced stage at diagnosis (HR: 2.5, 95%CI: 1.7-3.8), presentation with jaundice (HR: 1.7, 95%CI: 1.1-2.4) or ascites (HR: 2.8, 95%CI: 1.8-4.4), and positive serum carcinoembryonic antigen (HR: 2.3, 95%CI: 1.2-4.3). Patients who had received standard treatment had a better prognosis that those who did not (HR: 0.5, 95%CI: 0.3-0.7).
